Disease progression in Plasmodium knowlesi malaria is linked to variation in invasion gene family members

Autor: Ahmed, Atique M., Pinheiro, Miguel M., Divis, Paul C., Siner, Angela, Zainudin, Ramlah, Wong, Ing Tien, Lu, Chan Woon, Singh-Khaira, Sarina K., Millar, Scott B., Lynch, Sean, Willmann, Matthias, Singh, Balbir, Krishna, Sanjeev, Cox-Singh, Janet
Přispěvatelé: The Wellcome Trust, University of St Andrews. School of Medicine, University of St Andrews. Gillespie Group, University of St Andrews. Infection Group, University of St Andrews. Biomedical Sciences Research Complex
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Zdroj: PLoS Neglected Tropical Diseases, Vol 8, Iss 8, p e3086 (2014)
PLoS Neglected Tropical Diseases
ISSN: 1935-2735
1935-2727
Popis: Emerging pathogens undermine initiatives to control the global health impact of infectious diseases. Zoonotic malaria is no exception. Plasmodium knowlesi, a malaria parasite of Southeast Asian macaques, has entered the human population. P. knowlesi, like Plasmodium falciparum, can reach high parasitaemia in human infections, and the World Health Organization guidelines for severe malaria list hyperparasitaemia among the measures of severe malaria in both infections. Not all patients with P. knowlesi infections develop hyperparasitaemia, and it is important to determine why. Between isolate variability in erythrocyte invasion, efficiency seems key. Here we investigate the idea that particular alleles of two P. knowlesi erythrocyte invasion genes, P. knowlesi normocyte binding protein Pknbpxa and Pknbpxb, influence parasitaemia and human disease progression. Pknbpxa and Pknbpxb reference DNA sequences were generated from five geographically and temporally distinct P. knowlesi patient isolates. Polymorphic regions of each gene (approximately 800 bp) were identified by haplotyping 147 patient isolates at each locus. Parasitaemia in the study cohort was associated with markers of disease severity including liver and renal dysfunction, haemoglobin, platelets and lactate, (r = ≥0.34, p =
Author Summary Plasmodium knowlesi, a parasite of Southeast Asian macaques, has entered the human population. Approximately 10% of P. knowlesi infections are severe, 1–2% are fatal, in Sarawak, Malaysian Borneo. Increase in parasitaemia is associated with disease severity, but little is known about parasite virulence in this newly described human pathogen. Here we present the results of a study on P. knowlesi parasites collected from 147 patients. We use the isolates to produce DNA sequences from a polymorphic (genetically variable) region of two P. knowlesi genes, Pknbpxa and Pknbpxb, that are involved in parasite entry into host red blood cells. We addressed the question that some parasite genotypes may have an invasion advantage leading to severe disease in human infections. We analysed the DNA sequences with matched clinical and laboratory data from the patient cohort (n = 147). We found that specific DNA sequences (Pknbpxa and Pknbpxb alleles) clustered with high parasitaemia and markers of disease severity. Here, for the first time, we provide evidence that variant alleles of the Plasmodium Reticulocyte Binding-Like Protein invasion gene family can influence disease progression in patients with malaria. The biological characteristics of the variants will be studied to aid our understanding of malaria pathophysiology and to inform intervention strategies.
Databáze: OpenAIRE